INFLUENZA - PREVENTION

Case Report:
A 10 months old boy presented with severe breathlessness for one day. He had mild cough and cold for the past 2 days for which he had received some medications from his physician. On examination, he was breathless with respiratory rate of 72/min with heart rate of 160/min. Capillary refill time was 3 seconds. He has chest indrawing with subcostal and intercostal retractions and flaring of alae nasi. He was cyanosed. On respiratory system examination, there were bilateral crepts and wheezing. He had a tender hepatomegaly. Other systems were normal. In view of impending respiratory failure, he was immediately intubated and positive pressure ventilation was started. Investigations showed severe hypoxia on arterial blood gas (pH = 7.28, pO2 - 62, oxygen saturation - 82% and pCO2 - 36). His complete blood count showed anemia (hemoglobin of 10gm%), white cell count of 25,000/cumm (20% polymorphs and 89% lymphocytes) and platelets of 1,80,000/cumm. His Chest X ray showed bilateral fluffy shadows. He was thus suspected to have ARDS and put on high frequency ventilation. However he succumbed to his illness after 24 hours. His throat swab that had been sent for H1N1 PCR was positive. The doctors took oseltamivir prophylaxis for 10 days in view of contact with this patient.